| NPI | 1295124667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY D POPE Owner 214-691-2404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: TX 24589) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: TX 9710) |
| Enumeration Date | 2015-01-22 |
| Last Update Date | 2015-01-22 |